Community Health Workers in an Interdisciplinary Outpatient CKD Clinic to Optimize Social Care Navigation, Patient Engagement, and Home Dialysis Utilization The CHOOSE Home Trial

What this Trial Is About

This research aims to evaluate whether the CHOOSE Home intervention can increase the use of home dialysis among patients with advanced chronic kidney disease (CKD) who are at high risk. The study focuses on improving patient engagement and addressing health-related social needs (HRSNs) by integrating a Community Health Worker (CHW) into an interdisciplinary care (IDC) clinic. Researchers seek to determine if this approach can lead to more patients selecting or starting home dialysis over one year, as well as improvements in patient-reported social needs and engagement. Participants will be randomly assigned to one of two groups. One group will receive the CHOOSE Home intervention, which includes the support of a CHW to help with social care navigation and peer support alongside the usual interdisciplinary care for CKD. The other group will receive only the usual interdisciplinary care without CHW support. Both groups will complete surveys, questionnaires, or interviews at the start, six months, and one year during the study. During the study, researchers will monitor participants' choices and use of home dialysis over one year. They will assess changes in patient activation and health-related social needs from baseline to six months and one year. Participants will be followed and evaluated through surveys and interviews to understand how the intervention affects their care experience. The study is sponsored by Montefiore Medical Center and will take place from December 2025 through May 2028.

Community Health Workers in an Interdisciplinary Outpatient CKD Clinic to Optimize Social Care Navigation, Patient Engagement, and Home Dialysis Utilization